1. Field of the Invention
The present invention relates to an endoscope apparatus, which is inserted into a patient's body cavity and used in high-frequency incision of an organic tissue, such as a duodenal papilla, or in confining an indwelling tube in a narrow segment, such as a biliary duct.
2. Description of the Related Art
In general, high-frequency incision or indwelling tubing in a patient's body cavity is carried out as a technique for treating the interior of the patient's body with use of an endoscope. After the endoscope is inserted in advance into the body cavity, in the high-frequency incision, a high-frequency knife is inserted into the body cavity through an instrument channel of the endoscope. Subsequently, high-frequency current is supplied to the knife, and an organic tissue in the body cavity is incised by means of the knife.
In the indwelling tubing in the body cavity, moreover, a guide wire is inserted into a narrow segment of the organic tissue through the instrument channel of the endoscope. Subsequently, an indwelling tube is inserted into the body cavity with use of the guide wire as a guide. Then, the tube is left in the narrow segment and used for drainage or the like.
For example, a high-frequency incision apparatus for endoscope is described in Jpn. Pat. Appln. KOKAI Publication No. 8-71081 (Patent Document 1). In this apparatus, the outlet of a lumen of a duodenal papilla, for example, is incised with high-frequency current.
In this apparatus, an electrically conductive wire is passed through an elongate flexible sheath. A high-frequency knife is connected electrically to the distal end portion of the wire. A control section is mounted on the proximal portion of the sheath. The control section is provided with an electric plug, a liquid feed connector, etc., which are connected electrically to the wire.
In using this apparatus, the high-frequency knife is inserted into a patient's body cavity through an instrument channel of an endoscope that is previously set in the body cavity. The knife is caused to approach the outlet of the lumen of the duodenal papilla as a target region, high-frequency current is supplied to the knife, and the lumen outlet is incised.
A biliary duct catheter is described in U.S. Pat. No. 5,921,971 (Patent Document 2). This catheter is provided with a guide wire lumen. The proximal portion of the catheter is formed having a liquid feed connector and a connector through which an elongate guide wire is passed. The catheter is inserted into a patient's body cavity through an instrument channel of an endoscope. Further, the guide wire is passed through the guide wire lumen of the catheter. Liquid feed or other operation can be carried out with the distal end portion of the guide wire kept close to a biliary duct.
The catheter can be also used in evacuating the biliary duct of pooled bile or the like. In doing this, an indwelling tube is guided to a narrow segment of the biliary duct through the channel of the endoscope. The indwelling tube is confined in the narrow segment, and bile in the biliary duct is discharged through the bore of the tube.
The endoscope is provided with a control section on the proximal end portion of an elongate insert section. The control section has an instrument inlet. The proximal end portion of an instrument channel is coupled to the instrument inlet. An insert section of an instrument, such as the high-frequency incision apparatus or the catheter apparatus described in Patent Document 1 or 2, is inserted into the instrument channel through the instrument inlet. The insert section of the instrument has flexibility such that it can bend tracing the curvature of the insert section of the endoscope. Thus, the insert section of the instrument inevitably hangs down unless those parts which project outward from the instrument inlet, e.g., the control section, connector portions on the proximal end portion of the insert section, etc., are held in a hand.
In carrying out incision by means of the high-frequency incision apparatus or indwelling tubing, therefore, a doctor usually holds the control section of the endoscope, while an assistant, such as a nurse, holds the guide wire, catheter, or some other instrument, in many cases. In these cases, the doctor gives instructions to the assistant while watching a monitor, and the assistant manipulates the instrument in accordance with the doctor's instructions.